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An allegation of insufficient advice

14 July 2014
Giving written advice to a patient after treatment is a worthwhile precaution to take, in light of the details of this case...

A patient who attended infrequently presented to a dentist as an emergency with pain from a lower second molar. After careful visual and radiographic examination, the dentist advised the extraction of the tooth since it was very carious and heavily restored.

The extraction under local anaesthetic was uneventful and after checking that haemostasis had occurred, she advised the patient to return for a proper examination.

Unfortunately, the patient did not return and the dentist was surprised to receive a letter one month later, from a lawyer, alleging negligence. It appeared that the patient experienced considerable pain from the extraction site that evening and had resorted to vigorous rinsing with a solution of brandy and sugar.

The patient attended a doctor who prescribed antibiotics, but the pain from the dry socket took three weeks to resolve and the patient had taken a number of days off work resulting in lost income.

Insufficient advice

The allegation revolved around insufficient post-operative advice. In fact the dentist had given very specific verbal and written post-operative instructions detailing after-care of the socket which advised against rinsing and smoking.

The written sheet also gave instructions about after-hours emergency advice. Upon production of this written advice sheet together with the clinical records confirming that the patient had been given the sheet, the patient’s legal representatives dropped the case.

Learning point:
Written instructions are a simple precaution to adopt as an adjunct to verbal warnings, particularly in cases where the patient may forget the advice through nerves, side-effects of treatment or their general level of mental ability.
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